Florida Child Care Resource & Referral Provider Update Form

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Florida Child Care Resource & Referral Provider Update Form 2011-2012

Name of Person filling out form: __________________________ Date form was completed: __________________________

Do you wish to have your program referred to families seeking child care listings from the Child Care Resource & Referral Office:

YES NO

Please return form to us by:

Date:

Early Learning Coalition of Sarasota County

Child Care Connection 2886 C Ringling Blvd Sarasota, FL. 34237 941-556-1600 ext. 106 941-556-1606 (fax)

www.earlylearningcoalition

sarasota.org

Family Child Care Home or Business Name:

(as it appears on License)

CCR&R Name:

Address:

City: Zip

Code:

Mailing Address: same as above

Telephone Number: Alternate/Emergency Telephone

Number:

E-mail: Fed. ID No./ SSN:

Registration/License#: Director Name:

Fax#:

Family Child Care Home Only:

Do you want your house number and street name to appear on referral lists to families? __YES __NO 1. ACCREDITATION - Are you accredited by any organization? (Check all that apply)

Gold Seal Accreditation Religious Exempt Accreditation

Accred. Professional Preschool Learning Envir. (APPLE) Assoc. Christian Schools International (ACSI) Assoc. Christian Schools International (ACSI) Assoc. Christian Teachers & Schools (National) Assoc. Christian Teachers & Schools (ACTS) Assoc. Christian Teachers & Schools

Council on Accreditation (COA) Christian Schools of Florida Montessori School Accred. Commission (MSAC) Church Avenue Academy

National Accreditation Commission (NAC) Church of God Association of Christian Schools Natl. Assoc. for the Education of Young Children (NAEYC) Early Childhood Christian Education Association National Association for Family Child Care (NAFCC) Florida Assoc. of Christian Schools & Colleges, Inc. National Council for Private School Accreditation (NCPSA) Florida Catholic Conference

National Early Childhood Program Accreditation (NECPA) Florida Kindergarten Council

National School-age Care Alliance (NSACA) Florida Coalition of Christian Private Schools Association Southern Association of Colleges & Schools (SACS) Fl League of Christian Schools

United Methodist Assoc. of Preschools (UMAP) Green Apple Association of Christian Schools National Accred. Council for Early Childhood Prof. Prog Light of the World Christian School

Miracle Faith Center

Narrow Door Pentecostal

A COPY OF YOUR CERTIFICATE IS REQUIRED

National Association for Christian Education

IN ORDER FOR ACCREDITATION TO BE LISTED.

Natl. Assoc. for the Education of Young Children

National Lutheran School Accreditation (FL-GA district)

Effective date on Certificate ___/___/____ New Beginnings Christian Center Accreditation (NBCCA) Expiration date on Certificate ___/___/____ Nicene Schools International

Papa Goose Network of Christian Nursery’s

Sonshine Association of Christian Schools

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4/12/2011 Agency for Workforce Innovation’s Office of Early Learning

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3. CURRICULUM - Which of the following curriculum does your program use? (Check all that apply)

Beyond Centers & Circle Time

_Wee Learn

Other (list)

Creative Curriculum

Active Learning Series

DLM Early Childhood Express School Readiness Express

Doors to Discovery DECA

Galileo

Kindness Curriculum

High Reach(approved for family child care providers)

I love You Rituals-Becky A. Bailey

Reggio Emelia approach (must be

used by teachers trained in this approach

Optimistic Classroom

4. VACANCY/ENROLLMENT/CAPACITY:

What is your total licensed capacity? (number of children you are licensed to care for) What is your actual capacity? (most number of children you choose to care for)

In the chart below please indicate:

The number of vacancies available at the present time in each age group

The actual number of children enrolled (combining both full & part time children enrolled) in each age group The maximum number of children you offer services to by age group

The number of children enrolled in VPK by age group (either 4 or 5 years old) Enter results by number

of children by age group:

Infant 1 year old 2 year old 3 year old 4 year old (not in VPK) 5 year old (not in VPK) Elementary School Age (B/A Only) * Middle School Age (B/A Only) * Number of Vacancies at the present time:

Actual number of children enrolled:

Maximum number of children you will accept

Number of children enrolled in VPK (not included in above total)

* If a Private School do not include the private school students in the counts 5. ENVIRONMENT - Describe your program’s setting. (Check all that apply)

Accommodates Allergies

German Negotiated Rate Sliding Fee Scale

Bilingual Greek Smoke Free Facility Spa on site

Chinese Green Certified Building No TV School Readiness

Agreement

Cat Habla Espanol Provider participates in

Operation Military Child Care

Teen Parent Program

Corporate Hebrew Outdoor Play United Way

Creole Italian Parent Co-op Vietnamese

Diapers provided Limited English Pets Video Monitoring

Dog Large FCCH Pool on Site Wheelchair Accessible

English Limited Spanish Portuguese Web Cam on site

Employer Contract Licensed School Age SR Agreement

Private School Other (list below) Exempt School Age

SR Agreement

Provides Meals Russian

French Medicaid Provider Fluent Spanish

Fenced Yard Military Scholarships Available

Filipino Multi Child Discount Sign Language

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6. ADDITIONAL FEES - Please list all additional fees that your program charges.

Description Amount How often is this fee charged?

(See Codes Below)

Is this fee per child or family? (C/F)

Activity $

Annual $

Application $

Dance lessons $

Xtra Curricular Activities $

Field Trips $ Gymnastics lessons $ Holiday $ Insurance $ Late pick-up $ Late payment $ Meals/Snacks $ Music lessons $ Overtime/Early Drop-off $ Returned check $ Registration $ Summer Camp $ Supplies/Materials $ Swimming lessons $ Transportation $ Other: $

Frequency Codes: Both Ways; Every 10 minutes; Half Hour; Hourly; Minutes; Every 5 minutes; Yearly; Every 15 minutes;

Monthly; One Time; One Way; Weekly; Daily.

7. MEALS - What meals does your program provide? (Check all that apply)

Afternoon Snack Lunch Special Diet Requests

Breakfast Morning Snack USDA Food Program

Bring Own Lunch/snacks Parent Supplies Formula

Dinner Provides Formula

8. PROGRAM PARTICIPATION - Is your program/facility a…? (Check all that apply)

Child Care Center Military (on base program) Summer Camp

Family Child Care Home (FCCH) Nanny/Au-pair VPK School Year program

Head Start Playgroup VPK Summer program

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9. RATES: In the table below enter the advertised rates (private pay rates) your program charges.

Do not include voucher/subsidy rates, sliding scale rates, employee discounts or any other discounted rates. Only complete the rate type for each age group that you offer.

You must submit a public rate sheet as well. If you do not want to fill out the rates below,

please write in “See Attached Rate Sheet”

RATES –ENTER BY AGE GROUP (see note above)

Enter Rate by Age of Children Infant 1 year old 2 year old 3 year old 4 year old (not in VPK) 5 year old (not in VPK) Elem School Age Mid School Age FULL- TIME Circle frequency: Weekly/Monthly/Annually

FULL time VPK WRAP Circle frequency: Weekly/Monthly/Annually PART-TIME Circle frequency: Weekly/Monthly/Annually

PART –TIME VPK WRAP

Circle frequency: Weekly/Monthly/Annually

School Age –BEFORE SCH.

School Age –AFTER SCH.

School Age – BOTH BEFORE & AFTER SCH.

SUMMER

10. SCHEDULE - What days of the week does your program operate? (Check all that apply)

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

What are your hours of operation? Open Time: circle AM or PM Close Time: circle AM or PM What are the ages you serve? From (minimum age):

Sample: 2 months to 6 years

_____________ To (maximum age): _________ Years

11. ENHANCED SCHEDULE - Does your program provide the following schedule? (Check all that apply)

24-Hour Care Full Time Rotating

After School Full Year Summer Only

Both Full & Part-Time VPK Wrap Care Follow local School System Weather Days

Before School Morning School Year

Drop In Care Open if Safe Weather Vacation/Holiday

Emergency/Temp. Care Overnight Weekend Care

Evening Care Part Time

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12. ENHANCED SERVICES - What other services does your program offer? (Check all that apply)

Computers Health/Social

Services

Outdoor Sports Training/experience with children with developmental delays

Art/Crafts Homework/Tutor Small Group Size Training/experience with

making environmental accommodations for children with special needs

Family Involvement Kindergarten Class Swim Lessons Therapeutic Services

Field Trips Music Lessons Training/experience

with children with autism spectrum disorder

Other (list here)

Gymnastics/Dance Lessons

On-site Screenings Training/experience with children with behavioral challenges 13a. Total number ________ of staff that work directly with children in care.

13b. STAFFING - Enter below the number of staff that work directly with children in care that have any of the following qualifications/degrees/courses/credentials/training:

#__ FCCH completed 2nd Helping course #__ Provider/staff has Early Literacy training

#__ Provider/staff has AA/AS Degree non-child related #__ Provider/staff had first aid training within past 2 years

#__ Provider/staff has AA/AS Degree in early childhood #__ Provider/staff has High School Education/GED

#__ Director Credential Advanced #__ Provider/staff has MA Degree non-child related

#__ Director Credential Foundational #__ Provider/staff has MA Degree in early childhood

#__ Provider/staff has BA/BS Degree non-child related #__ Facility has medical staff onsite

#__ Provider/staff has BA/BS Degree in early childhood #__ NAFCC FCCH Observer Trained

#__ Provider/staff has CDA credential #__ Provider/staff does not have High School/GED

#__ Provider/staff has CDA equivalency #__ Special Needs Training (describe)

#__ Provider/staff had CPR training within past 2 years #__ Provider/staff has VPK Director Credential

#__ Provider/staff has Doctorate

14. SUBSIDIES - Does your program currently serve children who receive child care subsidies (School Readiness) or financial assistance to pay for their care? Yes No

School Readiness Agreement Voucher-Other Agencies (list)

15. SUBSTITUTION POLICY - What is your programs substitution policy? (Check all that apply and list schools below)

Friend Substitute Pool

Spouse Relative

Other Substitute (list here):

16. TRANSPORTATION - Do you or the school provide transportation? (Check all that apply) From school to site (list school names) From site to home To school from site (list school names) To site from home

Near public transportation In walking distance to school (list school names below): By school bus or van

17. For each of the following positions, please enter the average salary or hourly wage and the average number of hours worked per week

Position Hourly/Salaried position? Average Salary/Wage Average number of hours worked per week

Center Director/FCCH Operator

Hourly (per hour)

Salaried (per year) $ hours

Head or Lead Teachers Hourly (per hour)

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Teacher Assistants/Aides Hourly (per hour)

Other (please list)

Hourly (per hour)

18. Are any of the following benefits available to staff?

Benefit Available to full-time staff? Available to part-time staff? Not available to any staff? Health Insurance

Dental Insurance Disability Insurance Retirement Plan Paid vacation

Paid sick time/personal days Reduced rates for children of staff

Financial assistance to cover courses (college courses) Financial assistance for in-service workshops, conferences, etc Paid parental leave Other (please list)

19. What are the most common reasons staff stated for leaving? (Check all that apply)

Pay Benefits Conflict with co-workers/employer

Relocation Family issues Burn-out

Better job opportunity Other: Lack of career ladder

within the child care field outside of the child care field

20. What are the most common reasons staff have stayed? (Check all that apply)

Pay Benefits Commitment to teaching/joy of

teaching

Family friendly workplace Managerial support Good working relationship with co-workers/employer

Other:

21. How many times a month, on average, is your program short a teacher?

Less than 3

14 to 16

4 to 6

17 to 19

7 to 9

Over 20

10 to 13

How many classrooms in your program?

Comments/Questions:

Florida Child Care Resource & Referral Provider Update Form